The invention relates to a method for prevention of a parastomal hernia in a patient.
Incisional hernias can be a significant problem after open abdominal surgery. As an example parastomal hernia is a common complication after the construction of enterostomas with a rate of more than 30% in general surgical practice. Bringing out the enterostomy through a laparotomy wound has been disastrous in terms of infection, wound dehiscence and herniation. [Y. Cengiz and L. A. Israelsson, Parastomal Hernia, European Surg., Vol. 35 p. 28-31, February 2003].
Bringing out the stoma through the rectus abdominis muscle has been associated with a lower rate of parastomal hernia. After repair of parastomal hernia, the lowest rates of recurrence have been achieved with methods using a prosthetic mesh in a sublay technique [Petersen S., Henke G., Zimmerman L., Aumann G., Hellmich G., and Ludwig K., Ventral Rectus Fascia Closure on Top of Mesh Hernia Repair in the Sublay Technique; Plast Reconstr., Surg. 2004December; 114(7):1754-60].
The best measure would be to prevent the formation of a parastomal hernia [Israelsson L A., Preventing and Treating Parastomal Hernia, World J Surg 2005; 29: 1086-9]. This principle has been reported and the first randomised clinical trial in this field was by Janes et al. [Janes A., Cengiz Y., Israelsson L A., Preventing parastomal hernia with a prosthetic mesh., Arch Surg 2004, 139:1356-8; Janes A., Cengiz Y., Israelsson L A., Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia., Br J Surg 2004; 91:280-2]. Janes et al. found a prophylactic effect of incorporation of a sublay light weight mesh placed at the operation where the ostomy is performed.
Despite these disclosures, there is a need for improved treatment of hernias